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Individual

ELIZABETH MATHEW PULLUKALA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2098 KNOTTINGHAM TRACE LN, JACKSONVILLE, FL 32246-1396
(904) 525-3684
Mailing address
2098 KNOTTINGHAM TRACE LN, JACKSONVILLE, FL 32246-1396
(904) 525-3684

Taxonomy

Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
APRN11025870
FL
208M00000X
Hospitalist Physician
APRN25870
FL
363L00000X
Nurse Practitioner
11025870
FL

Other

Enumeration date
10/18/2023
Last updated
04/16/2026
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